How much rates vary
Facilitymedian $2,291 · 10th to 90th $100 to $4,467Professionalmedian $60 · 10th to 90th $39 to $120
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $38.90 Median $58.88 Typical High $181.97 | Facility | None | $38.90 | $58.88 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $58.88 Typical High $83.18 | Professional | None | $38.90 | $58.88 | $83.18 |
Anthem BCBS Setting Facility Modifier None Typical Low $933.25 Median $3,162.28 Typical High $4,897.79 | Facility | None | $933.25 | $3,162.28 | $4,897.79 |
Anthem BCBS Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $123.03 | Professional | None | $51.29 | $61.66 | $123.03 |
CDPHP Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $4,073.80 | Facility | None | $1,348.96 | $1,348.96 | $4,073.80 |
CDPHP Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $104.71 | Professional | None | $63.10 | $63.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $1,096.48 | Facility | None | $75.86 | $100.00 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $123.03 | Professional | None | $28.18 | $57.54 | $123.03 |
Emblem Health Setting Facility Modifier None Typical Low $30.20 Median $50.12 Typical High $162.18 | Facility | None | $30.20 | $50.12 | $162.18 |
Emblem Health Setting Professional Modifier None Typical Low $97.72 Median $107.15 Typical High $181.97 | Professional | None | $97.72 | $107.15 | $181.97 |
Excellus BCBS Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $93.33 | Professional | None | $47.86 | $72.44 | $93.33 |
Highmark BCBS Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
MVP Health Care Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
MVP Health Care Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $154.88 | Professional | None | $52.48 | $52.48 | $154.88 |
United Setting Facility Modifier None Typical Low $363.08 Median $1,148.15 Typical High $4,365.16 | Facility | None | $363.08 | $1,148.15 | $4,365.16 |
United Setting Professional Modifier None Typical Low $30.20 Median $57.54 Typical High $114.82 | Professional | None | $30.20 | $57.54 | $114.82 |
Univera Setting Facility Modifier None Typical Low $33.11 Median $69.18 Typical High $151.36 | Facility | None | $33.11 | $69.18 | $151.36 |
Univera Setting Professional Modifier None Typical Low $47.86 Median $72.44 Typical High $93.33 | Professional | None | $47.86 | $72.44 | $93.33 |
5 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $19.50 Median $29.51 Typical High $34.67 | Professional | 52 · Reduced service | $19.50 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $11.75 Typical High $13.80 | Professional | 53 · Discontinued | $7.94 | $11.75 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.89 Median $8.71 Typical High $10.23 | Professional | 55 · Aftercare only | $5.89 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $5.89 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.89 | $5.89 | $6.92 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $47.86 Typical High $54.95 | Professional | 53 · Discontinued | $38.02 | $47.86 | $54.95 |
Where New York sits
The same service costs 3.3 times more in Alaska than in New Jersey. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
New York· 46th of 51
$61.66
AK $191NJ $57.54
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.